Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTreatment of fractures of the humeral capitulum using fibrin sealant.
Three patients with fresh displaced fractures of the capitulum humeri were treated by the fibrin sealant method, without additional internal fixation. At follow-up, between 1 1/2 and 4 1/2 years after surgery, clinical results were very good. Fibrin sealant has many advantages over traditional osteosynthesis techniques and is therefore recommended as an effective method for treating such serious but uncommon fractures of the elbow joint.
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Arch Orthop Trauma Surg · Jan 1990
Separate centre of ossification of the lateral malleolus with instability of the ankle joint.
Four cases of recurrent instability of the ankle joint are reported. The instability was associated with a separate centre of ossification of the lateral malleolus and abnormal movement between the ossicle and the distal fibula. All patients were successfully treated by surgery: two underwent internal fixation and ligamentous reconstruction and two, ligamentous reconstruction after removal of the ossicle.
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A transverse fracture of the proximal part of the fifth metatarsal is rarely caused by direct trauma but is usually secondary to overload. These fractures, when treated conservatively, have a high recurrence rate and give rise to prolonged sporting inactivity. The clinical and radiographical difference between an acute versus a stress fracture will decide on further treatment. A reversed graft, by an asymmetrical trapezoid autograft, offers a simple and effective surgical solution for nonunion and delayed union of Jones fractures in sportsmen.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsBizarre parosteal osteochondromatous proliferation of a phalanx.
A rare proliferative osteochondromatous malformation of a proximal phalanx is described. This malformation may mimic the appearance of a sessile osteochondroma or parosteal osteosarcoma on X-rays and may be mistaken for a low-grade osteosarcoma on histology, with disastrous therapeutic consequences. We found that cryotherapy followed by local excision was adequate to remove the tumour.
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Arch Orthop Trauma Surg · Jan 1990
Total decompression of the spinal cord for combined ossification of posterior longitudinal ligament and yellow ligament in the thoracic spine.
One of the causes of hyperostosis in the spinal canal, ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the yellow ligament (OYL) in the thoracic spine, can result in serious myelopathy, leading to sandwich-type compression of the spinal cord from anterior and posterior. For such cases we devised a treatment of total decompression of the spinal cord and intervertebral body fusion. This operation consists of two steps. ⋯ This pre-treatment makes removal of the OPLL anteriorly during the second stage much easier, faster, and safer. This operation is lengthy and demanding. However, based on our experience so far, it appears to be a promising surgical procedure.